We read with great enthusiasm the manuscript by Richards et al. titled “Damage Control Resuscitation in Traumatic Hemorrhage: It Is More Than Fixing the Holes and Filling the Tank.”1  This comprehensive review significantly contributes to our understanding of resuscitation strategies in traumatic hemorrhage, emphasizing the importance of a multifaceted approach to patient care.

While the manuscript effectively encapsulates various critical aspects of damage control resuscitation, we wish to highlight an area not extensively covered in the discussion—management strategies for patients experiencing the direst consequences of traumatic injuries, including exsanguination cardiac arrest and cardiac arrest caused by blunt cardiac injury, airway trauma, severe pulmonary contusion, and other causes of severe hypoxia. These scenarios necessitate familiarity with the latest advancements in emergency response techniques. Standard resuscitation techniques in these patients are unlikely to produce effective organ perfusion and often result in poor outcome, with mortality of nearly 100% reported for...

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